Cirrhosis Non-alcoholic fatty liver disease
What is Cirrhosis Non-alcoholic fatty liver disease?
Progression from NAFLD to Cirrhosis NAFLD progresses through several stages:
- 1. Simple Steatosis: Initially, fat accumulates in the liver, but there is little to no
inflammation or liver damage. This stage is often asymptomatic.
- 2. Non-Alcoholic Steatohepatitis (NASH): A more severe form where inflammation and liver
cell damage occur in addition to fat buildup. NASH can progress to fibrosis, where scar
tissue forms in the liver.
- 3. Fibrosis: Over time, the inflammation and damage can lead to the formation of scar
tissue (fibrosis). Although the liver can still function relatively well, the damage is
beginning to accumulate.
- 4. Cirrhosis: In this advanced stage, extensive fibrosis disrupts the liver’s structure and
function, leading to cirrhosis. The liver becomes severely scarred and hardened, losing its
ability to perform essential functions such as detoxification, protein synthesis, and bile
production.
Symptoms of Cirrhosis
In the early stages, cirrhosis may be asymptomatic or present with non-specific symptoms such as
fatigue, weakness, and weight loss. As the disease progresses, more severe symptoms can
develop, including:
- Jaundice (yellowing of the skin and eyes)
- Ascites (accumulation of fluid in the abdomen)
- Edema (swelling in the legs and ankles)
- Variceal bleeding (bleeding from enlarged veins in the esophagus or stomach)
- Hepatic encephalopathy (confusion, altered consciousness due to liver dysfunction)
Diagnosis
Cirrhosis due to NAFLD is often diagnosed through a combination of medical history, physical
examination, blood tests, imaging studies (such as ultrasound or MRI), and sometimes liver
biopsy. Blood tests may show abnormal liver enzymes, and imaging can reveal the extent of liver
scarring. A liver biopsy, though invasive, is the definitive method to assess the severity of
liver damage.
Treatment
The treatment of cirrhosis in the context of NAFLD focuses on managing symptoms, preventing
complications, and addressing the underlying causes. Key strategies include:
- Lifestyle Changes: Weight loss, a healthy diet, and regular physical activity are
crucial. These can slow or halt the progression of NAFLD and may even reverse early stages
of fibrosis.
- Medications: While there are no specific drugs approved for NAFLD or NASH, medications
may be used to control associated conditions like diabetes, high cholesterol, or
hypertension.
- Management of Complications: In advanced cirrhosis, treatment focuses on managing
complications such as ascites, variceal bleeding, and hepatic encephalopathy.
- Liver Transplantation: In cases of decompensated cirrhosis, where the liver is severe
damaged and no longer functions adequately, a liver transplant may be the only viable
option.
Prevention
Preventing the progression of NAFLD to cirrhosis involves early intervention and lifestyle
modifications. Regular monitoring and management of risk factors such as obesity, diabetes, and
hyperlipidaemia are essential.
